课件：甲状腺癌PBL.ppt

Multiinstitutiona? phase?2?trial?of?pazopanib?monotherapy?in?advanced?anaplastic?thyroid?cancer. J Clin Endocrinol Metab.?2012 Sep;97(9):3179-84. Epub 2012 Jul 6. 靶向药物-帕唑帕尼2 Sixteen trial patients were enrolled; 15 were treated,11 of 15 had progressed through prior systemic therapy. Four patients required one to two dose reductions; severe toxicities (grades 3) were hypertension (13%) and pharyngolaryngeal pain (13%). Treatment was discontinued because of : disease progression (12 patients), death due to a possibly treatment-related tumor hemorrhage (one patient), and intolerability (radiation recall tracheitis and uncontrolled hypertension, one patient each). Median time to progression was 62 d; median survival time was 111 d. Findings 靶向药物-舒尼替尼 Phase 2 clinical trial of sunitinib as adjunctive treatment in patients with advanced differentiated thyroid?cancer. Eur J Endocrinol.?2016 Mar;174(3):373-80. doi: 10.1530/EJE-15-0930. Epub 2015 Dec 15. This was a single center, nonrandomized, open-label, phase 2 clinical trial. In total, 23 patients were enrolled and were treated with a starting daily, oral dose of 37.5 ?mg sunitinib. Patients were evaluated with imaging, laboratory tests, and physical examination periodically per protocol. Methods Six (26%) patients achieved a partial response (PR), and 13 (57%) had stable disease (SD) for a clinical benefit rate (PR+SD) of 83%. The overall median PFS was 241 days . The most common adverse events included grades 1 and 2 decreases in blood?cell?counts (especially leukocytes), diarrhea, fatigue, hand-foot skin reaction, nausea, musculoskeletal pain, and hypertension. Results 凡德他尼：FDA批准用于症状性或进展性髓样癌; XL184：FDA批准用于进展期转移性甲状腺髓样癌 靶向药物-其他 诊断 甲状腺扫描： 99mTc或131I同位素扫描，一般可将甲状腺结节分为四类： ① 热结节：多见于自主性毒性甲状腺肿。 ② 温结节：表示摄碘功能与周围正常甲状腺组织大致相同。 ③ 凉结节：表示结节摄碘功能低于其邻近的正常甲状腺组织。 ④ 冷结节：表示结节完全没有吸碘功能。 甲状腺癌的同位素扫描图像多为冷结节和凉结节，很少温结节， 热结节罕见。 谢 谢 甲状腺癌 (thyroid carcinoma)是最常见的甲状腺恶性肿瘤，是来源于甲状腺上皮细胞的恶性肿瘤，绝大部分甲状腺癌起源于滤泡上皮细胞 * 结节性甲状腺肿与甲状腺癌的相互